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Biomedical subjects

F Nakajima

Publications and source records attributed to F Nakajima.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Clinical study on Fournier's gangrene--value of "through and through drainage"].

From 1991 to 1994, we experienced 5 patients with Fournier's gangrene. Their age, associated diseases, etiology, area of the disease, microbiologic findings, treatment and prognosis were reviewed. Patient age ranged from 25 to 72 years, with a mean age of 47 years. An associated disease process could be identified in all patients. Two patients had diabetes mellitus, 1 systemic lupus erythematosus, 1 chronic alcoholism and 1 multiple myeloma. The etiology of the infectious process was presumed to be wound infection in 2 patients and indwelling urethral catheter in 2 patients. All patients were treated with broad-spectrum antibiotics. Extensive débridement with later skin graft was done in 2 patients. Multiple Penrose-drains were placed subcutaneously after limited removal of necrotic tissue in 3 patients. In these 3 patients, redness and swelling reduced quickly, the wound was cured without defects of skin except 1 patient who had multiple myeloma and was in a very serious condition. Although inflammation reduced after the placement of drains, the patient with multiple myeloma died of sepsis and DIC. The majority of patients with Fournier's gangrene are immunocompromised. Although extensive débridement is commonly performed as the surgical treatment, defects of the skin seem to have some disadvantages, such as the need for the skin graft and the chance of secondary wound infection. In the narrow excision of necrotic tissue and drainage of involved areas by multiple Penrose-drains, skin defects are minimum, and the effectiveness of the surgical management seems to be competitive with the wide débridement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[The advantage of a thin flexible ureteroscope with a new real-time processing system].

To observe the upper urinary tract more clearly with a thin flexible endoscope, we developed a novel real-time processing system. This system enhances the parts of the dark cladding around the core by individual strong brightness of each image fiber. The upper urinary tract in eight patients was examined using a thin flexible endoscope with this system at retrograde pyelography or at urological operation. Six patients had hydronephrosis and 2 had filling defects in the renal pelvis or calyx. The endoscope was 0.75 mm in diameter and had 300 pixels of image fiber. The objective portion could be assessed successfully in seven of eight. Significantly finer and colorful image could be obtained with this system compared with the conventional method and the epithelium could be clearly observed. We conclude that this real-time processing system remarkably improves the quality of image obtained with the thin flexible ureteroscope and makes it a more promising modality in the diagnosis and treatment of the upper urinary tract.

Adult↗
PubMed1995

[Study on clinical courses of 7 patients undergone resection of adjacent organs in the treatment of locally extensive renal cell carcinoma].

Significance of surgical extirpation of a massive tumor involving adjacent viscera is still controversial, because this sort of extensive resection is unusual and its results are poor in terms of a short survival time. Here, we summarize the clinical courses of 7 patients who had been diagnosed as invasive renal cell carcinoma (RCC) and undergone extensive resection of the bowel and/or other adjacent visceras. In addition, a percentage of patients who had direct invasion and/or metastasis to adjacent viscera in routine autopsies was looked up in the Annual Report of the Pathological Autopsy Cases in Japan. Pathological diagnosis indicated that direct invasion was confirmed in 4 out of 7 patients. One patient was relieved from septic shock due to pelvicocolic fistula caused by a direct invasion of RCC. New metastases developed in all patients after the radical operation (2 - 30 mos), and 3 of them further underwent resection of the metastastic lesion(s). Although 5 patients ultimately died of cancer or its related diseases (mean survival time: 14.2 +/- 10.7 mos), other 2 (pT4 and pT3) who underwent resection of lung metastasis have survived for 19 and 72 months. Either an early occurrence of metastasis after local resection or a tumor predominantly composing of spindle cells might indicate a poor prognosis. Surgical extirpation should not be precluded when the patient is having severe symptoms related to extensive involvement of the adjacent visceras. We believe that it is appropriate to individualize in case of choosing patients for such extended radical surgery.

Aged↗
PubMed1995

[Expression of GP160 mRNA in renal cell carcinoma: an attempt to predict the sensitivity of IFN-alpha therapy].

BACKGROUND: Alpha-interferon (IFN-alpha) has significant antitumor activity against advanced renal cell carcinoma (RC). Although numerous clinical trials reported major responses in approximately 15% of patients subjected to INF-alpha therapy, it has been impossible to predict which patients will respond to IFN-alpha. RC cell lines could be subdivided into those that are inhibited by IFN-alpha and those that are not. The expression of GP160 (Aminopeptidase a/kidney-associated differentiation antigens) correlated with resistance to IFN-alpha. In RC xenografts using a mouse model, though GP160(+) RC cell lines were resistant to IFN-alpha, GP160(-) RC cell lines were markedly sensitive to IFN-alpha. METHOD: In this study, we assayed 26 RC patients for the expression of GP160 in mRNA level using RT-PCR (reverse transcription polymerase chain reaction). RESULTS & CONCLUSION: In 23 (88.5%) patients GP160 mRNA expression are remarkable as in normal kidney tissue, but in 2 (7.7%) patients, GP160 mRNA expression was weak. And in 1 (3.8%) patient, GP160 mRNA expression was hardly detectable, and in this patient complete remission was achieved with IFN-alpha therapy for advanced lung and mediastinal metastatic RC.

Adult↗
PubMed1995

[Primary seminoma of the prostate and embryonal cell carcinoma of the left testis in one patient: a case report].

A 27-year-old Japanese male presented with gross hematuria and right frank pain, and was diagnosed of having a right ureteral stone by IVP. Though the stone was passed spontaneously, gross hematuria continued, and his urinary stream became week. The prostate was moderately enlarged. The prostate biopsy was initially thought to represent prostate rabdomyosarcoma. He underwent a pelvic extenteration followed by chemotherapy with dacarbazing and ADM. Three years after the pelvic exenteration, coin lesions were found on a chest X-ray film. He was diagnosed as embryonal cell carcinoma of the left testis with pulmonary metastasis and received 3 courses of PVB therapy. At this time, the former diagnosis of prostatic rabdomyosarcoma was changed to prostatic rabdomyosarcoma was changed to prostatic seminoma, because placental-ALP staining was positive. This patient had two distinct germinal cell tumors in the prostate and the left testis. He was alive without any tumor recurrence 20 months after PVB chemotherapy. To the best of our knowledge our report represents the first patient of seminoma of the prostate in the world.

Adult↗
PubMed1994

Immunotherapy with anti-CD3 monoclonal antibodies and recombinant interleukin 2: stimulation of molecular programs of cytotoxic killer cells and induction of tumor regression.

Adoptive cellular immunotherapy, infusions of interleukin 2 (IL-2) in conjunction with in vitro-activated killer cells, has brought new hope to patients with cancer. The broad application of this strategy, however, is constrained by the need for repeated leukapheresis and by the labor-intensive process of in vitro activation of cells. Also, current protocols generally use nonphysiological and toxic concentrations of IL-2. Identification of an in vivo stimulant that renders T cells responsive to physiologic concentrations of IL-2 represents a potential improvement over existing approaches. We have determined whether in vivo administration of monoclonal antibodies (mAbs) directed at the T-cell surface protein CD3 induces T-cell responsiveness to IL-2, stimulates cytolytic molecular programs of natural killer cells and cytotoxic T cells, and induces tumor regression. These hypotheses were explored in a murine hepatic MCA-102 fibrosarcoma model. We report that in vivo administration of anti-CD3 mAbs plus IL-2 results in intrahepatic expression of mRNA-encoding perforin, cytotoxic T-cell-specific serine esterase, and tumor necrosis factor alpha. Anti-CD3 mAbs alone or IL-2 alone failed to induce or induced minimal expression of these molecular mediators of cytotoxicity. The anti-CD3 mAbs plus IL-2 regimen also resulted in a significantly smaller number of hepatic metastases and a significantly longer survival time of tumor-bearing mice, compared to treatment with anti-CD3 mAbs alone or IL-2 alone. Our findings suggest that a regimen of anti-CD3 mAbs plus IL-2 is a more effective antitumor regimen compared with anti-CD3 mAbs alone or IL-2 alone and advance an alternative immunotherapy strategy of potential value for the treatment of cancer in humans.

Animals↗
PubMed1994

Identification of the gene encoding a novel HLA-B39 subtype. Two amino acid substitutions on the beta-sheet out of the peptide-binding floor form a novel serological epitope.

Serological analysis suggests the existence of a novel HLA-B39 subtype (HLA-B39N) in the Japanese population. To identify this novel allele, a gene encoding HLA-B39N was cloned and the exons were sequenced. A gene encoding HLA-B39N (B*3904) and B*39011 differs by two nucleotide substitutions at codons 11 and 12 whereas B*3904 and B*39013 differ by three nucleotide substitutions at codons 11, 12, and 312. One nucleotide difference at codon 11 produces a change from serine in B*3901 to alanine in B*3904 whereas another difference at codon 12 changes valine in B*3901 to methionine in B*3904. The residues 11 and 12 are located on the beta-sheet out of the peptide-binding floor and are completely buried in the molecule. These results suggest that the substitutions at these residues alter the conformation of other residues forming epitopes of alloantibodies. Analysis of HLA-B*3901 genes in the Japanese population showed that both B*39011 and B*39013 were observed in the Japanese population. The present study suggests that B*3904 may have evolved from B*39011 rather than B*39013.

Amino Acid Sequence↗
PubMed1994

Primary leiomyosarcoma of the ureter.

Malignant tumors of the ureteral smooth muscle are rare and the prognosis is not clear. This is a report of a patient with primary leiomyosarcoma of the ureter surviving 9 years and 9 months postoperatively without any evidence of recurrence. Malignancy of the ureter was suspected on the basis of angiography and radical nephro-ureterectomy was performed without positive cytology results.

Adult↗
PubMed1994

[Transitional cell carcinoma of bladder occurring during pregnancy: report of two patients].

Primary transitional cell carcinoma (TCC) of the bladder occurring during pregnancy is extremely rare and only 16 patients have been reported in the literature. Patient 1: A 24-year-old primigravida at 33 weeks of gestation presented with gross hematuria. Cystoscopy revealed a large bladder tumor. After delivery TUR-Bt was performed. Because of frequent reccurrences after TUR-Bt, radical cystectomy was done. Pathological study revealed transitional cell carcinoma, G1-G2, pTa. Patient 2: A 34-year-old gravida 11 at 6 weeks of gestation presented with gross hematuria. Cystoscopy revealed a papillary bladder tumor. TUR-Bt was performed after artificial abortion. Pathological study revealed papillary transitional cell carcinoma, G1 > G2, pTa. Eighteen patients of TCC of the bladder occurring during pregnancy were reviewed. Fifteen of the 18 patients presented with gross hematuria. All patients had superficial, solitary, grade 1 or 2 papillary TCC, except one grade 3 patient. Cystoscopy should be considered in all pregnant women with gross hematuria. Small TCCs of the bladder during pregnancy can be treated safely by TUR-Bt during pregnancy or after delivery.

Adult↗
PubMed1993

Design and syntheses of a series of novel serotonin3 antagonists.

From a structural comparison study between serotonin and serotonin3 (5-HT3) antagonists using a two-dimensional grid template composed of regular hexagons, we deduced structural modification patterns from agonists to antagonists, and designed new 5-HT3 antagonist prototypes. Among them, 2-(4-methyl-1-piperazinyl)-1-butylbenzimidazole (6) was identified as a lead compound which has potent 5-HT3 antagonistic activity comparable to that of granisetron. Using a quantitative structure-activity relationships method, we optimized the structure of 6 and selected 6-amino-5-chloro-1-isopropyl-2-(4-methyl-1-piperazinyl)benzimidazole dimaleate (69, KB-6933), one of the most potent and long-acting 5-HT3 antagonists, as a candidate drug.

Animals↗
PubMed1992

Effects of ouabain on muscle tension and intracellular Ca2+ level in guinea-pig aorta.

The effects of ouabain on muscle tension and the intracellular Ca2+ level ([Ca2+]i) were examined in guinea-pig aorta loaded with fura-2. Ouabain caused a gradual and sustained increase in both [Ca2+]i and muscle tension. There was a positive correlation between these two parameters. In Ca(2+)-free solution, ouabain did not affect either [Ca2+]i or muscle tension, suggesting that the ouabain-induced increase in [Ca2+]i was not due to Ca2+ release from storage sites. The ouabain-induced increase in [Ca2+]i and muscle tension was inhibited by Ni2+, which inhibits the Na+/Ca2+ exchanger, but not by verapamil. Furthermore, anionic and cationic amphiphiles were used as modulators of the Na+/Ca2+ exchanger. Sodium dodecyl sulfate accelerated the responses to ouabain, whereas dodecyltrimethylammonium bromide inhibited them. These results suggest that in the guinea-pig aorta, ouabain induces contraction by increasing the Ca2+ influx through the Na+/Ca2+ exchanger on the plasma membrane, but not through verapamil-sensitive Ca2+ channels.

Animals↗
PubMed1992

[Recombinant human granulocyte-colony stimulating factor (rhG-CSF) treatment for spleen abscess and periostitis in a patient with chronic granulomatous disease].

A 9-year-old boy with chronic granulomatous disease was hospitalized on May, 1991, because of continued fever and pain in the right elbow. Increased bone intensity at the distal end of right humerus on x-ray and a 33 x 36 mm space-occupying lesion in the spleen on abdominal CT scan were recognized. Under a diagnosis of periosteitis and spleen abscess, intravenous infusion of rhG-CSF at a dose of 200 micrograms/m2/day was started in combination with antimicrobial therapy. Fever, tenderness, swelling in the right elbow and inflammatory indices improved three weeks after the institution of therapy. Hydrogen peroxide (H2O2) formation by neutrophil increased significantly, although intermittently, during the therapy. The spleen abscess had completely vanished on CT scan on February, 1992. The therapy was well tolerated and no significant side effects were observed. The use of rhG-CSF in combination with potent antibiotics is recommended for patients with serious infections in chronic granulomatous disease to avoid a fatal course.

Abscess↗
PubMed1991

Treatment for stage III-IV neuroblastoma patients: initial response to chemotherapy evaluated by biochemical parameters.

Fourteen patients with stage III-IV neuroblastoma were treated with alternating combination chemotherapy consisting of (a) VP16/cisplatin and (b) doxorubicin/vincristine/cyclophosphamide. The initial response to induction chemotherapy, especially to VP16/cisplatin was evaluated by determining t 1/2 for urinary vanillylmandelic acid (VMA), homovanillic acid and serum neuron specific enolase (NSE). The period prior to normalization of these parameters was also determined. The patients could be classified as 7 rapid responders, with less than 3 weeks of t 1/2 VMA, or t 1/2 NSE, and 7 slow responders longer than 4 weeks of t 1/2 VMA. An analysis of the data indicates that an initial rapid response correlated with subsequent high complete response rate, but did not necessarily predict better prognosis in these patients.

Abdominal Neoplasms↗
PubMed1991

[The suction effusion fluid is useful as a sample for blood biochemistry].

We examined whether the suction effusion fluid could be used as a new sample for blood biochemistry. The fluid was obtained from the skin surface of female mongrel dogs by transcutaneous suction after removal of the horny substance. The appropriate intraluminal pressure for suction was 300 mmHg at which the effusion fluid flow rate was 0.6 microliter/min/cm2. The blood biochemistry examination revealed that the creatinine (Cr) and urea (BUN) concentrations in the suction effusion fluid were similar to those in plasma and that the protein and lipid concentrations were much smaller than those in plasma. The six-hour study showed that the effusion fluid could be obtained for hours at the same skin area and that the Cr and BUN concentrations were consistently close to those in plasma. In uremia models, the Cr and BUN concentration in the suction effusion fluid was similar to and had an extremely high correlation (r = 0.985 and 0.982 respectively) to that in plasma through out the range for clinical practice. The skin biopsy revealed that the regeneration of the horny substance had started at one week after the suction and complete recovery was seen at four weeks. The invasiveness of the suction seemed to be small. The suction effusion fluid is a reliable material for measurement of Cr and BUN in plasma and, as it contains much less proteins and lipids, will be a good sample for biosensors.

Animals↗